IHS1477995 - TAB 3 - PWS.pdf

07t08t2023

SCOPE OF WORK

Contractor Podiatrist

1.0 Purpose: This performance work statement descrlbes the requirements for a non-personal services contract for a Podiatrist, Doctor of Podiatric Medicine, to support the mission of the Crownpoint Service Unit of the Navajo Area of the lndian Health Service. Contractor shall provide Podiatry services for the Crownpoint Service Unit at the following (lHS) facility:

1.1 Backeround: IHS is an agency within the U.S. Department of Health and Human Services and is responsible for providing federal health services to American lndians and Alaska

Natives. The provision of health services to members of federally recognized tribes grew out of the special government to government relationship between the federal government and Indian tribes. The IHS is the principal federal health care provider and health advocate for the lndian people. The goal is to assure that comprehensive, culturally acceptable personal and public health services are available and accessible to Amerlcan lndians and Alaska Natives. The IHS currently provides health services to approximately 1.5 million American Indians and Alaska Natives who belong to more than

557 federally recognized tribes in 34 states.

1.1.1 Navaio Area lndian Health Service (NAIHS) administers health centers and hospitals providing health care to approximately 201,583 members of the Navajo Nation. The Navajo Nation is the largest lndian tribe in the United

States and has the largest reservation, which encompasses more than 25,516 square miles in northern Arizona, western New Mexico, and southern Utah, with three satellite communities in central New Mexico.

The NAIHS is the primary provider of inpatient, ambulatory care, preventive and community health, and envlronmental health services for members of the Nava.jo Nation and the San luan Southern Paiute Tribe.

1.2 Scope of Work: Contractorshall provide examination, diagnosis and medical, mechanical or minor surgical treatment of the foot, ankle and soft tissue structures below the distal metaphyseal flare of the tibia in the clinic setting. Contractor is expected to provide services at dates and times assigned by the Clinical Director typically Monday through Thursday 7:30 am to 6 pm. Duties and responsibilities may include outreach cllnics at Thoreau Health Clinic and Pueblo Plntado Health Clinic and consultation in the Emergency Room.

Crownpoint Healthcare Facility of Crownpoint Service U nit.

Pueblo Pintado Health Clinic

Thoreau Health Clinic

1.2.2

!.2.3 Period of Performance: This contract will be for 1 base year with 4 option years.

lndividual assignments shall be flexible to allow for short term (13 weeks), long term (1-year) and, where feasible, include intermittent support to meet unplanned needs that develop on a frequent basis.

1.3 Applicable Documents: Please see the web link listed unless document is listed as an attach ment

1.3.1 The Joint Commission

http://www.iointcommission.orgl

1.3.2 Centers for Medicare and Medicaid Services (CMS) Standards http://www.c ms. h hs.gov/

1.3.3 Accreditation Association for Ambulatory Health Care (AAAHC) http://www.aaa hc.org

1.3.4 Section 23L of Public Law 101-647, the Crime Control Act of 1990.

http:1/www.policya lma n ac.org/crime/a rchive/crs federal crime policv.shtml

1.3.5 Section 4087 of Public Law 101-630, the lndian Child and Family Violence Act htto ://www.n icwa.orsloolic y/law/protection/i ndex.asp

1.3.6 Health Insurance Portability and Accountability Act (HIPAA) of 1996.

htto://www.cms. h hs.eovlH lPAAGen lnfo/Down loads/H lPAALaw. pdf

1.3.8 IHS Service Unit and Health Center Policies, Procedures and Protocols (See section 1l-.0 for a list of attachments and exhibits)

1.3.9 Computer Security Act of 1987

http://csrc. n ist.eovlerou ps/SM A/ispa b/docu ments/csa 87.txt

1.3.10 Federal Code of Conduct http://www. ihs.gov

Place of Performance: Services are to be performed at crownpoint Healthcare Facilty in

Crownpoint, NM or satellite clinics at Thoreau and Pueblo Pintado

1.3.7 Privacy Act of 1974.

http ://www.usdoi.sovloi p/privstat. htm

1.3.11 IHS General Directives htto://www. ihs.gov/ad min mserresouces

L.3.12 IHS Computer Security Directives http://www. ihs.sov/ad min mesresou rces

2.O Definitions

2.1 Acceptance: Constltutes acknowledgement that the supplies or services conform to the applicable contract quality and quantity requirements, except as provided in FAR subpart 46.5 and sub.ject to other terms and conditions of the contract.

2.2 Approval: Acknowledgment by the designated Government official that submittals, deliverables, or administrative documents (e.g., insurance certificates, installation schedules, planned utility interruptions, etc.) conform to the contractual requirements. Government approval does not relieve the Contractor from responsibility for compliance with contract req u irements.

2.3 Code of Ethics: The American Podiatric Medical Association's Code of Ethics for Podiatric Medical Doctors.

2.4 Contracting Officer (CO): A Government employee with the authority to enter into, administer, and/or terminate contracts and make related determinations and findings.

2.5 Contractor: The individual awarded a legal binding contract to provide supplies and se rvices.

2.5 Contracting fficer's Representative (COR) or Project Officer (PO): A federal employee who assists the ordering/issu ing activity contracting officer in the administration of task orders issued under this contract. The COR is primarily responsible for the technical assistance and day-to-day program management of the ordering activity's task orders.

2.7 Cooperative Attitude: Behavior that is positive and displays a willingness to perform assigned patlent care tasks and to be a team player.

2.8 Cultural Awareness: Realization and respect for American lndian and Alaska Native practices

2.9 Customer: Patients, staff and visitors of an IHS service unit and health center.

2.10 Customer Evaluation/lnput: Written comments made to the Contracting Officer regarding the Contractors performance. This is one of the criteria used to evaluate the Contractor's performance.

2.11 Dependability: Qualities of being trusted and being able to repeat the same task to yield the same resu lt.

2.12 Federal Acquisition Regulation (FAR): The FAR is the primary regulation for use by all Federal Executive agencies in their acquisition of supplies and services with appropriated funds

2.13 Government Vehicle: An IHS owned motorvehicle ora vehicle leased by IHS through agreements with the General Services Administration (GSA) or through commercial rental agreements.

2.14 Health Center: A facillty physically separated from a hospital, with a full range of ambulatory services including at least primary care providers, nursing, and point of care lab testing which are available at least 40 hours a week for outpatient care.

2.15 Nonpersonal Services: A contract under which the personnel rendering the service are not subject, either by the contract's terms or by the manner of its administration, to the supervision and control usually prevailing in relationships between the Government and its employees, as defined in FAR 37

2.16 Orientation: An activity designed to provide baslc familiarization of the facility and transition the contractor into the Crownpoint Healthcare Facility and the Ambulatory Care department.

2.18 Patient Outcome: End result of outpatient visit

2.19 Performance based Matrix: as listed in Section 10.0, the criteria by which performance under this contract will be monitored.

2.22 Personal Protective Equipment (PPE): The equipment used to protect medical personnel from exposure to biological, chemical, and radioactive hazards.

2.23 Service Unit: The local administrative unit of IHS

2.24 Standards of Practice and Standards of Care: Authoritative statements by which the medical profession describes the responsibilities for which its practitioners are accountable. The standards provide direction for professional medical practice and a framework for the evaluation of practice. The standards of professional medical practice may pertain to general or spe( ialty practice.

2.25 Supervisor. Government employee authorized to provide verbal and written performance direction to the Contractor that the Contractor must follow without exception.

2.26 Task Order: An order issued in accordance with the terms of the contract that details an ordering activlty's specific requirements. A wrltten order to obtain services, at a minimum shall

2.17 Past Performance lnformation: Relevant information regarding a contractor's actions under previously awarded contracts. This includes the contractor's record of conformance to specifications and to standards of good workmanship; the contractor's record of containing and forecasting costs on any previously performed cost reimbursable contracts; the contractor's adherence to contract schedules, including the administrative aspects of performance; the contractor's history for reasonable and cooperative behavior and commitment to customer satisfaction; and generally, the contractor's business-like concern for the interest of the customeT.

include the following where applicable: description of services, skill categories, hours, price, period of performance, contract number, and the ordering activities task order number.

2.27 Yalid Patient Complaint: lustifiable accusation made by a patient and supported by investigation.

2.29 Verifiable Emergency: An unexpected/un pla nned absence by the contractor requiring valid documentatlon to confirm the occurrence.

3.0 GovernmentFurnished lnformation Pro and Services

3.1 lnformation: Government unique information related to this requirement, which is necessary for Contractor performance, shall be made available to the Contractor. The

Contracting Officer or designee shall be the point of contact for identification of any required information to be supplied by the Government.

3.2 Joint Use by the Government and the Contractor: Except for the property and service listed in 3.3 and 4.0, the Government shall provide, for oint use by the Government and the Contractor, all necessary equipment, supplies, and clinic space to perform the services under this contract.

3.3 Contractor Exclusive Use:

3.3.1 Personal Protective Equipment (PPE). The Government shallfurnish the Contractor with appropriate PPE other than specified in paragraph 4 of the contract. The Government shall be responsible for any repair, cleaning, and inventory required for the PPE. This does not include any type of uniform or laboratory coat.

3.3.2 The Government shall provide facility specific contractor identification badges for each contractor. A minimum fee of $10.00 shall be charged for lost or destroyed badges

3.3.3 Tokens: All Contractor Physicians appointed to the CHCF Medical Staff sha ll comply with the Drug Enforcement Agency and the State of New Mexico's two-factor authentication Electronic Prescription of Controlled Substances (EPCS) requirements. The

Contractor Physician shall be issued an HID USB token to meet identity verification for prescribing controlled substances within IHS and the HID USB token shall be compatible with CHCF's Electronic Health Record (EHR) and the Resource Patient Management System (RPtr/S). These tokens are provider specific, but can be used at other IHS facilities.

3.4 Training: Facility specific orientation/train ing necessary for the Contractor to perform the requlred duties, e.g., IHS information technology (lT) systems and operational procedures.

Training shall be provided ONLY if the sub.iect matter is necessary to lmprove or enhance the quality of service or lncludes mandates made by the IHS Service Units/Health Centers while working under this contract. Training shall not be provided for the purpose of continuing education, career development or individual development.

4.0 Contractor Furnished Properw

4.1 Except for the property specified in paragraph 3 as government furnlshed, the Contractor shall provide all uniforms and other personal medical instruments subject to the following:

4.1,.1 Uniforms and Lab Coats: Uniforms and Lab Coats shall conform to the requirements of the Indian Health Service lV4anual, Part 3 Chapter 4 and meet the approval of the Clinical Director at each IHS facillty.

4.L.2 Other personal medical instruments: "Other personal medical instruments" are defined as Contractor owned items may include but not limited to stethoscope, scissors, as appropriate to the work unit. The Contractor shall not use unsafe equipment or supplies at any time during performance of this contract. All Contractor furnished equipment and supplies shall be sublect to inspection by the Government and must be approved by the COR prior to use by the Contractor. The Government reserves the right to prohibit the use of any materials, supplies, or equipment.

The Contractor shall complete clinical reports and correspondence concerning patients under his/her care in a timely fashion.

Contractor shall maintain appropriate licensure and certification through the term of thejr contract.

The Contractor shall provide outpatient podiatry services in the delivery of patient care to the Indian Health Service. Specific tasks include the following:

5.1 Podiatrist Duties:

5.1.1 The Contractor shall provide comprehensive care of the diabetic foot, from diabetic foot exams to palliative care, including wound care and surgical management of infections with a goal of identifying high-risk patients and prevention of lower extrem ity a m putations.

5.1.2 The Contractor shall provide professional medical services and direct patient care services under the terms of this contract, appropriate and timely medical services in accordance with the standards of care established by recognized medical care organizations and in accordance with the policies and procedures of the Crownpoint Service Unlt.

5.0 DUTIES AND RESPONSIBILITES:

and

5.1.3 The Contractor shall utilize and interpret advanced diagnostic modalities includ ing CT sca ns.

5.1.4 The contractor shall perform minor surgical procedures under local anesthesia in the clinic settlng to treat bone and soft tissue infections, remove soft tissue masses treat hammertoe deform ities

5.1.5 The contractor is expected to be able to manage corns, calluses, fungal infectlons of the skin and toenails, ingrowing toenails, heel pain, ulcers, warts, tumors (Kaposi sarcoma, malignant melanoma, etc) and foot and ankle sprains.

5.1.6 Contractor shall provide consultation to the Emergency

Room, hospita listandother providers during normal business hours. (there is no call sched u le)

5.1.7 All documentation on patlents shall be completed prior to the contractor's shift is over. Delinquent charts shall be completed prior to the contractor completion of his/her contract at Crownpoint Healthcare Facility.

5.2 WorkSchedule:

5.2.1The Supervisor sha ll determine specific tour of duty. The contractor shall work 100% of the contracted hours. Timekeeping and attendance will be monitored in compliance with the terms of the contract.

5.2.2 Work Flexibility. The Contractor shall be scheduled to work in the Ambulatory

Care department. There will be some variability of schedule based upon the needs of the patients and staffing for the clinics. In general, 100 hours a month of podiatry clinic time is expected. Regular hours are 8:00 am to 5:00 PM with a minimum 30 minute unpaid lunch. In emergency situations, the contractor may be required to work additional hours. The extra hours will be charged at the same rate, and not exceed two hours at any one time. No "on-call" coverage is required for evenings, weekends or Federal holidays. Total hours are not to exceed 1040 hrs.

5.2.3 The Contractor shall provide written documentation from a qualified health care provider for absences of three (3) or more consecutive days, due to illness, statin g:

a. The cause of the current illness/incapacitation AND

b. lndicating the contractor as contagious or non-contagious.

The government reserves the right to examine and or re-examine any Contractor who meets the criteria.

5.3 Conduct: The Contractor shall meet standards as listed in the Federal Code of Conduct

5.4 Performance Evaluation:

5.4.2 Substantiated reports written by any customer dealing with patient safety, infection control, or other procedure that adversely affects patient outcome constitutes a breach of contract.

5.5 ldentification of Contractor:

5.5.1The Contractor shall wear a government issued contractor identification badge during performance of d uty.

5.6 Management of Medical lnformation: The Contractor shall manage all patient information in accordance with HIPAA standards, Privacy Act, and IHS Service Unit and/or Health Center specific policies and protocols.

Contractor is required to comply with all aspects of the Privacy Act (P. L. 93-579) and HIPPA regulations, and the use of confidential information and health records, to safeguard the privacy of patients and comply with the regulations of maintaining and keeping confidential patient information/docu me nts in a secure place. Contractor will be required to comply the requirements of P.L. 101-630, lndian Child Protection and Family Violence Prevention Act, by completing a character investigation. Will follow policies and procedure of IHS and CPSU guidelines and statues.

5.6.1 Medical Records and Other Required Documentation: 100% percent of all medical records and other required documentation meets established IHS Medical Facility, ioint Commision, and CVIS standards to include, but are not limited to, timeliness, legibility, accuracy, content, date, time, signature and designated profession. (Note:

payment shall be withheld for inaccurate or incomplete medical records per paragraph

10.0 of this performance work statement.)

5.6.2 The Contractor shall immediately report to the Contracting Officer or COR any information or circumstances that may violate any statute, policy, or procedure.

The Contractor sha ll obtain approval of the department Supervisor or designee prior to any absence from work. lf the length of the absence exceeds eight (8) work hours the Contractor shall request approval at least fifteen (15) davs. (the exception is verifiable emergencies) in advance of the desired absence.

5.4.1The Contractor's performance shall be evaluated in accordance with the standards set forth in the contract and Performance-based Matrix of section 10.0.

5.7 IHS lnformation Technology Systems:

5.7.1 ln performance of this contract, the Contractor shall adapt to and successfully utilize IHS information technology systems that are deemed by the Supervisor as necessary for acceptable contractor performance, including use of the Electronic Health Record (EH R).

5.7.2 The Contractor shall ensure that IHS information technology system security policies and procedures are adhered to. The lT policies and procedures shall be made available to the Contractor at each IHS facility.

Must be proficient in use of computers

5.0 Contractor Qualification Requirements:

5.1 Experience. The Contractor shall have completed a certified podiatry training program that grants the Doctor of Podiatric Medicine. Be Boa rd certified by one of the following podiatry boards: American Board of Multiple Specialties in Podiatry (ABMSP), American Board of Podiatric Surgery (ABPS), American Board of Podiatric Medicine (ABPM) or the American Board of Foot and Ankle Surgery ( ABFAS). Completion of a three year residency is required ( or preferred) Solek suggested this be o requirement to moke sure they hove enough surgery experience to be on expert consultont.

6.2 License/Registration. The Contractor shall hold a valid, active, and unrestricted podiatry license in at least one state.

5.3 Certifications. Current Basic Life Support (BLS) is mandatory

5.4 Health Requirements/Conditions of Employment

lmmunization. The Contractor shall also provide the following documentation

. lmmunity to Rubella, Mumps, l\rleasles

. lmmunity to Hepatitis B series

. History of chicken pox (varicella) disease or positive titer

. Tetanus Diphtheria (Td)within the last 5 years

. Documentation of receiving a TB Mantoux skin test (PPD) wlthin the past

12 months with documentation of follow-up for a positive test.

. A signed declination of the Hepatitis B vaccination series shall be accepted

5.5 Language Requirements and Cultural Awareness. The Contractor shall read, understand, speak, and write English to effectively communicate with patients and other health care workers, and shall be respectful of the local, American lndian and Alaska Native culture.

6.6 lnformation Technology Skills. The Contractor shall possess basic knowledge, skills, and abilities to use a computer. Completion of Information Systems Security Awareness training is mandatory. https://www. ihs.eov/issa/ Certificate of training needs to be submitted to the department supervisor one week before entry on duty date to start the process of electronic health record access.

6.7 Orientation. All podiatrists providing service under this contract shall attend mandatory orientations and training specified by the govern ment/su pervisor

6.8 Background Checks: As directed by the Contracting Officer, the Contractor sha ll provide allrequested information necessary to perform Level Iand Level ll background checks. The Contractor shall comply with the requirement to obtain security investigations. The Contractor shall work with the IHS to ensure that the pre-employment screening process includes the appropriate investigation questionnaires and forms to be completed. All completed forms shall be reviewed by the Contractor and forwarded to the responsible Government personnel. (mine eorlier version soid to the supervisor but these go stroight to the HR people doing cleoroncel. The Contractor shall be immediately removed from the position if at any time the investigation receives unfavorable adjudication, or, if other unfavorable information that would affect the investigation becomes known.

7.O lndemnification and Medical Liability lnsurance (JAN 1997): Nonpersonal services contract, as defined in Federal Acquisition Regulation (FAR) 37.101, under which the professional services rendered by the Contractor are rendered in its capacity as an independent contractor. The Government may evaluate the quality of professional and administrative services provided, but retains no control over professional aspects of the services rendered, including by example, the Contractor's professional medicaljudgment, diagnosis, or specific medicaltreatments. The Contractor shall be solely liable for and expressly agrees to indemnify the Government with respect to any liability producing acts or omissions by it or by its employees or agents. The Contractor shall maintain during the term of this contract liability insurance issued by a responsible insu ra nce carrier.

8.0 Challenges to Conflicts: For any inconsistency between supervisor directions, this Performance Work Statement, attachments and exhibits, the following order of precedence shall apply:

(a) First Priority:

(b) Second Priority:

Supervisor's directions Scope of Work

9.0 S2.249-l2Termination (Personal Services) (Apr 1984): The Government may terminate this contract at any time upon at least 15 days'written notice by the Contracting Officer to the contractor. The contractor, with the written consent of the contracting officer, may terminate thls contract upon at least 15 days'written notice to the Contracting Officer.

9.1 Any Contractor employee demonstrating impaired.iudgment shall not be allowed to continue worklng on the contract. The Government reserves the right to remove from the facility any Contractor employee who in the judgment of a licensed healthcare practitioner is impaired.

10.0 Performance - Based Matrix

Performance-based Task lndicator Quality Assurance lncentives

State the end results or outputs that you, the customer shall formally accept or reject.

For the requirement, state the feature(s) of end result that shali be surveilled.

For each "indicator," state a performance levelthdt, w'ren rrer, mea.s tle task has been performed satisfactorily.

This Standard describes "What Success

Looks Like."

For each "Standard", state the method used to check performance (i.e. random sampling. 100% inspection, periodic inspection, customer complaints), List Posltive and Ne8ative lncentives. Address method of linking payment to qualiW of service.

Contractor shall provide

Podiatry services in the de ivery of patient care to the Navajo Area lndian Health

Service-

Competency/Compliance

Patient Outcomes

Professionalism

Certifications

Documentation

100% compliance with IHS Service Units and/or Health Centers published Policies;

Procedures; Standards of Care; and hospital and department policy and Protocols.

No reports of breached patlent safety, infection contro, and other procedures that might adversely affect patient outcome.

Performance characterized by continual culturalawareness and focus on customer service. 100 % adherence to the Code of Ethics and Federal Code of Conduct.

Unlnterrupted c.edentialing as defined in

6.0 to 6.8 for period of contract.

100% of all medical records and other required documentation meets established IHS Medical Facility, Joint Comission, and CMS standards to include, but are not limited to, timellness, legibility, accuracy, content, date, time, signature and designated profession.

see QASP. Surveillance systems shall include periodic inspections and customer complaints.

Payment of contract price for satisfactorV service.

No payment for incomplete

Contractor performance shall be evaluated using the Contractor's Performance Assessment Report (CPAR).

The evaluation shall be considered when future IHS contract se ections are made.

Standard